What exactly is a High Ankle Sprain?

Well, I was thinking meniscus when I saw it. What did you think when you saw Robby Fabbri take that awkward tumble during the Canada v. Denmark game?

His MCL certainly looked torqued in a big way as well, but I am not sure you can tear it with that mechanism, so I was thinking the posterior horn of his meniscus might have been pinched.

Then I saw him in the soft cast with a ‘high ankle sprain’ – I don’t fancy the term but I guess it is accurate. When we learned about it in university it was called a ‘syndesmosis sprain’ – but I guess no one knows what you are talking about when you say syndesmosis, in fact they may step away with fear that it is contagious – so now it is a ‘high ankle’ sprain.

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Essentially, there is a syndesmotic ligament that connects the two bones of your lower leg (yes, there are two in there), the larger tibia (you shin bone) and the smaller fibula sitting to the outside of it.

Recall that the ankle is a ‘mortise and tenon’ joint and the syndesmotic ligament helps keep that mortise stable. When the ankle gets torqued like Mr. Fabbri’s did – the two bones of the lower leg get pulled apart and the syndesmotic ligament can get torn.

It can get torn a little – will likely get better in six weeks or so with immobilization (like a soft cast) or it can get torn a lot leaving an unstable ankle and this may require surgical fixation to restore that stable mortise and tenon arrangement.

An athlete with a syndesmosis sprain will typically have pain above the ankle that is made worse by turning the foot outward.

So this is not your typical ankle sprain, where you injure the ligaments down near your foot. The forces required to damage the syndesmotic ligament are typically quite high so they can take a little longer to heal.

And THAT my friend is what you need to know about the high ankle sprain.



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